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Home My Public Portal About5626 GOLDEN WEST AVE_Plumbing__' 76A667-CE817-11-57 APPLICATION FOR PLUMBING PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING �"" JOHN A. LAMBIE, County Engineer ADDRESS �4P A/. 6o L.O CASSATT D. GRIFFIN, Supt of Building LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. NUMBER FIXTURE OR ITEM - OWNER dam+ F ' .� WATER CLOSET + y MAIL A / BATH TUB ADDRESS 04 L/V SHOWER CITY TEL NO. � LAVATORY �O CONTRACTOR /4 C•jo'/G 4141 r�j_ t/,rl /n/�• » SINKADDRESS ,� C+•3 r •4 �•�.+iF !r(- 'L DISHWASHER 9. - CITY ( �?41�i 4`1/i'1 1-- CONTRACT ' aj TEL. NO. IES I STATE LAUNDRY TUB REGISTRATIOONSNO. f f 7 J COUNTY ❑ " CLOTHES WASHER •W- DISTRICT O. • GROUP ZONE READY FOR INSPECTION _ WATER HEATER GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD 1 APPROVALS @ $1.00 PER ITEM DATE INSPECTOR'S SIGNATURE 4 OR FIXTURE $ UNDER SLAB WORK PERMIT $ 00 ROUGH PLUMBING _ TOTAL FEE , j-0 GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE 1S CORRECT AND AGREE TO COMPLY HOT WATER HEATER WITH ALLDESCRIBED COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST S REQUIRED BY LOS ANGELES COUNTY AND STATE OF OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE UTILITY CO. NOTIFIED RESIDENTIAL PRO�'ERTY.EITTE f FINAL ROBERTA.WOOD. ®F VALIDATION SUPERVISING MECHANICAL ENG'R CK EL.0. CASH A� 76A667-CE4817 2-66 CITY OF TEMPLE CITY APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES B 263 DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS 5626 Golden West COLEMAN W JENKINS. SUP T OF BUILDING4 LOCALITY Temple City FOR APPLICANT TO FILL IN NEAREST Liveoak CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER C. Donn of r i WATER CLOSET $1.25 MAIL ADDRESS same J BATH TUB 1.25 , CITY TEL. NO. SHOWER 1.25 LAVATORY 1.25 CONTRACTOR General Installation Co. SINK 1,25 ADDRESS 6558 west Blvd. DISHWASHER 1.25 CITY Los Angeles TEL. NO. PL 3-2541 STATE LAUNDRY TUB 1.25 LICENSE NO C-36 151839_ CLASS CLOTHES WASHER 1.25 DISTRICT�NO GR0111'_ ZONE � PROCESS5? 19YZ WATER HEATER 1.50 GAS SYSTEM OUTLETS 1.50 INDUSTRIAL o WASTE APPROVAL OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD v 1 WATER SOFTENER 1 50 Ready for Inspection NowCD W a f/7 Z APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT S 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE 3 5O GAS PIPING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN,THE ABOVE DESCRIBED RETIAL TY UTILITY CO NOTIFIED SIGNATURE Gfy� OF PERMITTEE - FINAL K/--V)�LMATION JACK R. ALLEN M o CASH SUPERVISING MECHANICAL ENG'R. ( kr,9 1 4 3:o APR 3' 5 0 3.5 0 ' WORKERS'COMPENSATION DECLARATION 76A667A hereby affirm that-I have a certificate of consent to self cE e17 (z-66) APPLICATION FOR PLUMBING .PERMIT sure, or a certificate-of Workers'Compensation Insurance or Jcertifie • y thereof(Sec 3800,Lab C) ` COUNTY OF LOS ANGELES �� BUILDING AND SAFETY;- olicy ompany _ Certified copy is hereby furnished FOR APPLIC'ANT TO FILL IN (PRINT OR TYPE) BUILDING Certifie co y is filed with t n buildm c NUMBER FIXTURE OR ITEM • FEE ADORES LOCALITY d r WATER,CLOSET ; ate Applicant NEAREST' BATH TUB CROSS ST14 R FICATE OF EXEMPTION FROM W KERS' ; COMPENSATION INSURANCE SHOWER OWNER -LAVATORY MAIL �- is section need not be completed if the work involved ADDRESS t �y the permit is for one hundred.dollars ($100) or less.) SINK CITTEL NQ� U certify that in the performance of the work for which this DISHWASHER' t Pcc M:ermit is issued, I shall not employ any person iri_any manner CON RACTO 0, aS to become subject to the Workers' Compensation Laws CLOTHES WASHER ADDRESS. ate' Applicant SWIMMING POOL RECEPTOR �' LUa- , OTICE TO APPLICANT If, after making this Certificate of ' CITY TEL tn•, Ixemption, you should` become subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIC a z ' bsation provisions of the Labor Code, you must forth- LICENSE NO (J `/c gq,,,�� ,O.�.-,P,P_-omply with'such,proyisions.or this permit shall be WATER HEATER CLAS x✓emed revoked - GAS SYSTEM OUTLETS DISTRICT NO PR CESSED V LICENSED CONTRACTORS DECLARATION OUTLETS OVER �/ D hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM FINAL (commencing with Section 7000) of Division 3 of the Busr- VALIDATION ess'and Professions Code, and my license is in full force and DATE {fect. C - f FINAL _•, •tcense Nu—k— is Class BY OntractoDate � I am exempt fro he licensing r quirements as I am a Plan check fee 1u licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ acting in my professional capacity (Section 7051, Bus- iness and Professions Code) TOTAL FEE O 11c or Reg.No Date Plan check applicant HOME OWNER-BUILDER DECLARATION Name r hereby affirm that I ama exempt from the Contractor's Address L cense Law for the following.reason (Section 7031.5, Busi- City Tel.No ss and Professions Code) 0,3 3 0 A I, as owner of the property, am exclusively contracting with licensedcontractors to`construct the' project (Section 7044,,Business and Professions Code) 0 00 CONSTRUCTION LENDING AGENCY o Q O 0 v,. hereby affirm that there is a construction lending agency Or the performance of the work for which this permit is 0 7 1 '-8 1 sued(Sec. 3097,Civ C) Lender's Name ; ender's Address � certify that I have read this.application and state that-the ' bove information is correct.,I agree to comply with all County r SEE REVERSE FOR EXPLANATORY LANGUAGE ordinances and State laws regulating Plumbing, and hereby �uthonze re tahves of thi oun to enter u on he ab entio property ecti urposes Signature of ermitfee Dat . r - WORKERS'COMPENSATION DECLARATION -APPLICATION FOR PLUMBING PERMIT I.hereby, affirm that I'have a certificate of consent to self in- �6A66�A 490 sure,or a certificate of Workers'Compensation Insurance,or a certified copy thereof (Sec 3800, Lab nnC ) Policy No )W �►"5 C� Company i►C�PU+�` by 'COUNTY OF LOS.ANGELES DEPT. OF PUBLIC WORKS' ❑ Certified copy is hereby furnished BUILDING FOR APPLICANT TO,FILL IN (PRINT OR TYPE) 5&_ 2 ^y, / /n Certified copy is filed with the county'buildminspection ADDRESS' rrOO / ,L4��/ �VGtJ department NUMBER NUMBER FIXTURE OR ITEM @ FEE LOCALITY I& _ Dated 1 i& Applicant, �e —rip� � WATER CLOSET(TOILET) NEAREST CERTIFICATE OF EXEMPTION`FROM WORKERS'- BATH TUB COMPENSATION INSURANCE SHOWER OWNER ,�� • - (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this per- SINK CITY TEL NO mit is issued, I shall not employ any person in any manner so � as to become subject to the Workers'Compensation Laws DISHWASHER -p� .p� CONTRACTOR /e ev Date Applicant CLOTHES WASHER ADDRESS rNOTICE TO APPLICANT- If, after making this Certificate of Ex- tion,you should become subject to the Workers'Com en; SWIMMING POOL RECEPTOR em Y �^� P I P CITY � �� TEL NO sation provisions of the Labor Code, you-must forthwith comp- LAWN SPRINKLER SYSTEMS � • ly with such provisions or this permit-shall be deemed revok- t STATE LIC rr ed WATER HEATER LICENSE NO'�L2 Z� CLASS �- LICENSED CONTRACTORS DECLARATION DISTRICT NO PROCESSED BY I hereby affirm that lam licensed under provisions of Chapter GAS SYSTEM - OUTLETS D O 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER d and Professions Code, and my license is in full force and ef- - 5 PER SYSTEM FINAL q/, VALIDATION fect IHOSE BIB_ DATE License Number o Lic Class'if— c�i FINAL ACCT e s V Contractor 'T� �U�bate n _31 �� BY ��[) 4 J, r cc O I am exempt under Sec ❑ WB&P C for this reason 1 ITEMS Plan check fee TOTAL 43= 4 b n Date PLUMBING PERMIT ISSUING FEE$ , CHECK 4 .40 z 31 Signature TOTAL FEE Q CHANE o 00 SINGLE FAMILY . Plan'check a licant HOME OWNER-BUILDER DECLARATION PP I hereby affirm that I am exempt from the Contractor's License Name ��_��1 �! 7/90*Law for the following reason (Section 7031 5, Business and Professions Code) Address -152 b2`? . i AM 8e24 I, as owner of the property, will do the work and the City Tel No structure'is not intended or offered for sale(Section 7044, Business and Professions Code) , CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec,3097, Civ C ) - Lender's Name "0 V4 Lender's Address 1-certify that I have read this application and state that the , above information is correct I agree to comply with all County ordinances and State jaws regulating Plumbing„and hereby authorize representatives of this County to enter'upon the ab o -menti ne property � fo.r inspection purposes- •r� _9�' SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date i COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0008300015 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDR TR: 11131 LT: 17 5626 GOLDEN WEST AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802520 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LIVE OAK 8588-012-027 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY 07 BATHTUBS/SHOWERS 1.00 FIX 16.20 TENANT: 13 DISHWASHER(S) 1.00 FIX 16.20 ISSUED ON: PROCEssET BY: PLAN EXPIRES 25 LAVATORIES/SINKS 3.00 FIX 48.60 08/30/00 UT 02/27/01 47 WATER HEATER(S) 1.00 WTH 16.20 OWNER: TEL. NO: 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 FINAL DATEY: CODE: DONOFRIO CARLO;LILA M (626) 287-4609- 66 WATER PIPING > 3 IN 2.00 LIN 218.70 5626 GOLDEN WEST AV TOTAL FEES 359.85 TEMP 917802520 DESCRIPTION OF WORK PLUMBING FOR REMODEL APPLICANT: 0: WALTER WENDT (626) 451-9911- 6149 LOMA AVE SPECIAL CONDITIONS: TEMPLE CITY, CA 3ELES Co CONTRACTOR: NS CONSTRUCTION TEL. N451-9911- �� ,'� APPROVALS DATE INSPECTOR SIGNATURE WET AND6146 LOMA AVE LIC. NO UNDER SLAB WORK TEMPLE CITY CA 91780 432646 B WATER SERVICE / PLASTIC Y/N METAL Y/N ARCHITECT OR ENGINEER: TEL. NO: ROUGH PLUMBING LIC. NO 1111111 GAS PIPING GAS VENT FU'S")LC WGR(�/� WATER HEATER u 11 u U 3PLUMBIN TURES �. � WN SPRINKLERS Li7 , O ® GAS TEST �O (�—�1( UTILITY COMPANY 'fc CWv- Service Thai GRAY WATER SYSTEM * ADDITIONAL DATA ON FILE REPORT ID: DPR263 ROUTE TO: BS0508